September is already going on. In most countries, this month denotes the start of the academy year in the school system, thereby, I felt that this post would fit in well.

It has been addressed before on this blog the repercussions of arterial hypertension since early in life. However, there is an effect that most times is missed: the impact on the school performance in our children and adolescence.

Unlike some people might think, there is a connection.

Although it is well-known the influence of hypertension on several organs of the human body as kidney, heart and brain among others in adults. The impact on the brain since childhood has been barely described and most reports in the past were limited to gross neurologic events, such as facial palsy, seizure and stroke in children with malignant hypertension.

Nowadays, the medical community is focusing on the association of arterial hypertension and neurocognition since early in life.

Neurocognition: Any form of cognition (the mental process of thinking and understanding) that is associated with the functioning of one or more specific areas of the brain.

What has the medical community found out on this so far?

Children with newly diagnosed or untreated primary hypertension have decreased performance on neurocognitive measures of attention, learning, memory, and fine motor ability compared with those being normotensive regardless maternal education, race, ethnicity, age and sex.

Hypertension in early in life often clusters with other cardiovascular risk factors with further negative effects on cognition, including obstructive sleep apnea, metabolic syndrome, insulin resistance and hyperlipidemia (1,2)

Therefore, the impact of hypertension early in life on neurocognition is clear.

In addition, to make things more complicated, often the school environment may be stressful and challenging for some children which adds up stress to the equation; another variable proven to be strongly related with high blood pressure as I already published some time ago (3)

Then, my recommendation is this: check on any children or adolescent with a poor school performance. Hypertension might be backstage.

The diagnosis of arterial hypertension has made it increasingly complex over time. It is no longer just to tell a patient “you suffer from arterial hypertension”. Nowadays, there are more abnormal blood pressure categories added to the list as prehypertension, “white-coat” hypertension and “masked” hypertension. No doubts, the complexity of the human been plays its role in all this (1)

Many patients have been said over years that they had “emotional hypertension” since her or his blood pressure (BP) at the medical office was elevated even after several BP readings at prudent intervals during the consultation, whereas at home blood pressure remained normal.

The abovementioned situation was overlooked by the medical community for a long time and there was a long-standing thinking that it was simply the result of patient’s stress arising from the patient-doctor encounter at the clinic. However, as time went by, the so-called white-coat effect was study in-depth and as a result, the “white-coat” hypertension term emerged (2)